Expert guide: A GP’s guide to supporting your LGBTQIA+ teen
Discussion forum for parents in Australia
World Pride is an international celebration of the LGBTQIA+ community and is currently being hosted in Sydney, Australia!
Being part of the LGBTQIA+ community and discovering who you are can be a very confusing, challenging, stigmatising and a lonely experience for young people. As parents and carers, supporting our children and making sure they know that they are loved and accepted for who they are is so important. We know that being a parent of an LGBTQIA+ child can also be confusing and you may be unsure of how to support your young one.
In honor of world pride, we asked Dr Kat, a queer friendly GP who supports many wonderful LGBTQIA+ patients, questions from parents.
My daughter came out as gay and is being bullied at school. It’s really affecting her mental health and she has started self-harming. How do I get her support?
Watching your child struggle with their mental health, and to see them self harming, is a very upsetting experience for parents.
Self harming is often done as a way for people to cope with painful emotions or feelings, or to "feel something" rather than feel "nothing". It can present in many different ways, but always needs to be taken seriously, as it is typically a sign of deep distress, where the person does not know how to cope with that distress.
I would recommend starting with your GP, to talk about how to get psychological support to help with both general support for their mental health, as well as learning ways to handle their distress rather than self harming. This can be done through private psychologists, through organisations like headspace, or in more severe cases may be through a public mental health service like CYMHS (child and youth mental health service). I strongly recommend making a long appointment, as this often takes quite a bit of time to explore and decide on the best next steps.
A very helpful tool in the meantime to help with self harm thoughts is the "Calm Harm" app - it is a fantastic free app that gives many different tasks or activities to try in order to manage urges to self harm.
Click here to learn more about supporting your teen who is self harming
My son identifies as trans, and wants to have gender affirming surgery. I’m feeling worried and confused, can you tell me more about what this means?
Gender affirmation means different things for everyone!
For some this may only mean social transition, for example using their chosen name, preferred pronouns, and gender expression (wearing the clothes or hairstyles etc that match their gender identity). Others may want to go through legal transition, changing their name and/or gender legally.
For some, but not all, this may also involve medical or physiological transition. This may include medication including hormones, or surgery. For those who are seeking hormonal treatment or surgery, even amongst people who identify as the same gender, their goals may vary widely. For example, it may include "top" surgery (breast removal or augmentation), facial surgery (to change the face shape), or "bottom" surgery (genital reconfiguration), amongst others.
We often discuss with patients that it is not necessary to do all (or any!) of these to be trans, so once you find from your child about what surgery they have as their goal, a good resource to look at is www.transhub.org.au/surgery , which has more information on surgical options for trans people.
Click here to learn more about gender and your teen.
My teen has shared with me that they don’t like their body and mentioned something called gender dysphoria. I’ve noticed they’re eating less and exercising much more than they used to, should I be worried?
Unfortunately, while there is limited research in this space, unhelpful eating patterns and eating disorders appear to be more common amongst transgender and gender diverse people than cisgender people. While there is no single reason why the risk may be higher, transgender individuals often have rather intense and often negative feelings about their body, particularly those that are incongruent with their gender. For example, transgender men may dislike their hips, or breasts, and engage in unhealthy behaviours around food or exercise to lose weight and change their body shape.
I would recommend booking a long appointment with your teens GP to discuss this further and determine whether there is an underlying eating disorder present - but regardless, your teens feelings about their body and their relationship with food and exercise should be explored further to ensure they aren't engaging in unhealthy behaviours.
Click here to learn more about body image, eating disorders and your teen.
I want to make sure my daughter is educated on safe sex, but would like to be inclusive when we have the chat. Any tips?
That is a fantastic approach, as traditionally the majority of the focus has been around avoiding pregnancy and around heterosexual sex, which of course is not all inclusive!
It is of course important to discuss barrier protection if your daughter is having sex with someone with a penis, to avoid both STIs and pregnancy. However, a discussion around safe sexual practices around all forms of sexual contact is important, as many STIs can be spread through skin to skin contact, oral sex, anal sex, and sharing toys.
I tend to avoid talking about safe sex in terms of the gender of the partner, and keep the language general, as pigeonholing advice based on sexual orientation may not be inclusive - for example if your daughter identified as a lesbian, her sexual partners may include trans women, and therefore discussion around contraception and penetrative sex would still be important!
It is not always easy to navigate, but having ongoing discussions about safe sex and ensuring your daughter feels comfortable to ask questions is the most important thing. If in doubt
Click here to learn more about talking with your teenager about safe sex. You can also find more information about sexuality and teens here.
My teen is non-binary and wants to start taking hormones. What are the pros and cons of this?
This is a big and difficult topic! I spend a very long time talking about the pros and cons with patients before I prescribe hormones.
For non binary people, the goals of treatment can vary widely. They may specifically be looking for some side effects of hormonal therapy (e.g. deepening of voice on testosterone), but may not be happy with some others (e.g. hair growth, or acne).
The most important thing is to have an open and honest discussion with a doctor who understands the likely outcomes and can go through the individual pros and cons for each person - I recommend seeing a GP or endocrinologist who works specifically in this space to get more individualised advice.
If you would like to learn more, we have included some resources below. We also encourage you to reach out on our forums, and connect with other parents and carers in the community for support.
Transcend - Families, Parents and Carers
